Provider Demographics
NPI:1104973635
Name:CLINTON COUNTY BOARD OF EDUCATION
Entity type:Organization
Organization Name:CLINTON COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-387-6480
Mailing Address - Street 1:NORTH HIGHWAY 127
Mailing Address - Street 2:CLINTON COUNTY BOARD OF EDUCATION
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602
Mailing Address - Country:US
Mailing Address - Phone:606-387-6480
Mailing Address - Fax:606-387-5437
Practice Address - Street 1:CLINTON COUNTY BOARD OF EDUCATION
Practice Address - Street 2:NORTH HIGHWAY 127
Practice Address - City:ALBANY
Practice Address - State:KY
Practice Address - Zip Code:42602
Practice Address - Country:US
Practice Address - Phone:606-387-6480
Practice Address - Fax:606-387-5437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2102701600251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY2102701600Medicaid